Change of anticoagulant

[Hashihilary]

Hi wise ones, my GP practice has just called to ask if I am willing to change from rivaroxaban to adoxiban, in line with new NICE guidance. Apparently this is because the latter is less likely to cause bleeds. I have never had any problems with rivaroxaban, so am not sure whether I need to change. Do any of you have a view on this?

[sassy59]

If you have no problem then stay as you are.

[BobD Volunteer]

Edoxaban is cheaper is real reason. Don't be bullied.

[mjames1]

GP may be right.

pubmed.ncbi.nlm.nih.gov/347...

Jim

[Hidden]

Call me old fashioned ....or worse ..... but my GP tried to get me off Warfarin onto one of these new fangled A/c's and I bluntly outright refused. Left her in no doubt as to my position. If it ain't broke, don't fix it. Sure all this new stuff has all been roadtested but now its in the market place being scoffed by real people they are all showing their true colours with a range of side effects.

Stay put if it does you no harm.

John

[JaneChapple in reply to Hidden]

That happened to my hubby and again during the p@ndemic because he didnt want to go to the surgery. His dr said they would not be able to monitor his bloods if he rufsed and she would have to stop his script.

We ended up getting a second-hand INR machine from a lovely lady on here, so that put a sfop to their bullying!

These new drugs have not had many trials as far as I know and some dont or didnt have an antidote if you needed to have an op and bled during it. Happily he is still on Warfarin!☺️😩❤️

[CDreamer]

Apixaban or Edoxaban? If it’s to Apixaban - yes, if to Edoxaban - my vote would be no but as Bob says don’t be bullied. Ask your GP their reasoning? If it is clinical keep an open mind but if expense stick to what you know.

[Hashihilary in reply to CDreamer]

Yes CDreamer, it's edoxaban. I just said I would think about it. It was the practice pharmacist who contacted me at the request of one of the GPs I've never met, and the reasoning was supposedly clinical, but I suspected it was cost really, which is why I straight away jumped on to this platform. I'll stick with what I know I think!

[Tilly1957]

You don’t have to change if there is no medical reason why. As I understand it, the reasoning is purely cost. are you sure it was from the surgery. I had this, and although I agreed on the phone, I called the surgery a few days later to object. Apparently is a U.K. wide change handled by an outside agency, purely down to cost. My surgery had no issues putting me straight back onto rivaroxaban. Initially I had a letter, and phoned the nurse’s mobile number on it, I had no idea it wasn’t connected to the surgery. Both this nurse and my surgery said it’s down to cost x

[wilsond in reply to Tilly1957]

Do you know who the agency is Tilly? Xx

[Tilly1957 in reply to wilsond]

no, there was nothing on the letter to indicate it was from anyone except the surgery. It was the surgery who explained about it being an outside agency - and they did t sound too happy about it being out of their control 😱🥰 x

[wilsond in reply to Tilly1957]

Its very worrying

[Tilly1957 in reply to wilsond]

especially for those who are to do computer literate or afraid/unable to disagree with the powers that be. I am a mouthy old biddy, I like to know how, what and why, and if I don’t agree I will say so. Hence my current disagreement with my gp about his instruction ‘I must to go on statins’. Nothing to do with my cholesterol, but the risk I have already if developing heart disease, so as a preventative. Yet he refuses to refer me back to the cardiologist because my AF is becoming more frequent 🥰 x

[wilsond in reply to Tilly1957]

Yes same here,dont put up much quietly,in general as well as health!I do feel sorry for the vulnerable too,some surgeries have gone over entirely to online booking for everything,inc appointments!

You have the right to be referred. I wonder if a direct approach by yourself to the cardiology secretary,outlining your difficulties in getting referred might help? What have you to lose?

Long live old bats🙂

[Tilly1957 in reply to wilsond]

it had crossed my mind to contact the cardiologist’s secretary. I haven’t seen him for 5 years or so. The gp’s reason was that my answer to how did I feel when in af of ‘crap and tired’ wasn’t a sufficient reason. So while I completed the 2 week bp recording he asked for, I also recorded the 4 episodes of af I had, including being specific about the symptoms (breathless, chest pain etc ) 🤣 let’s see what happens now - I do like this gp, but …………

[wilsond in reply to Tilly1957]

Good plan! Yes I like my GP too but sometimes needs kicking up butt or explaining using lots of crayons! Good luck xx

[Tilly1957 in reply to wilsond]

yes! X

[Buffafly in reply to wilsond]

😂😂🤣

[wilsond]

There is a post I put up the other day,with a link to the Phamaceutical Journal. The only reason this is being pushed is cost. 14.3 million pounds being given to GPs to swop as many Apixaban patients to Edoxaban.

The fact that Apixaban is shortly due to reduce in cost as its now out for generic production has obviously passed Them by.

Edoxaban has no antidote,the only DOAC that doesnt,has more gastric side effects and less effective for obese patients or those with kidney issues.

I really get angry to see the way this is bring presented to patients as a bonus. Some being told ,much more convenient,only 1 tablet a day,and so on.

Even worse some are being automatically switched without warning!

If you are fine on your current A/C insist on staying on it.

Grr

[Ppiman]

I changed on Thursday from rivaroxaban to apixaban having read of a new study that compared stroke and haemorrhage and found in favour of apixaban. I thought then was the time as I had already stopped my rivaroxaban for a few days owing to a colonoscopy. My GP would have switched me to edoxaban, but after discussion, he was happy to prescribe apixaban.

Later I looked at the studies of all three, and it does seem that edoxaban and apixaban are broadly equivalent so I think I would have been happy with either. I'm not sure, either, that the study comparing the two was definitive as it wasn't a direct clinical trial but a derived computerised statistical study. Still - bleeding is always a concern, so I am glad to have changed.

Steve

[Sleepyzz]

I was changed from Warfarin to Edoxaban during covid, best thing that happened during that time. Have had no problems with it at all, I no longer need INR tests or have to worry about what I eat. If I do need a treatment that requires me to stop taking it the wait time is less than coming off of Warfarin. I have found I get less accidental bruising although it definitely works as I found out when I cut myself 🙄.

[Silvasava]

Ive been on Edoxaban since December 2019 after a stroke. Not had any problems with it

[Ramblingross]

I was on Rivaoxyban with no problems....about a year ago for no known reason other than cost they changed me onto Edoxaban... ..l have noticed no difference at all...